| NPI | 1265428643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 50-050900) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 55702) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2011-08-26 |